G0472 Medicaid reimbursement rates by state
Physical therapy. 20 state Medicaid programs publish a fee-for-service rate for G0472 at the physician psychologist level. Rates run from $11.09 in Maine to $101.39 in Texas, with a median of $41.72.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $41.72units vary by state
- Highest
- $101.39Texas
- Medicare (non-facility)
- —not on the physician fee schedule
G0472 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| TexasPhysical therapist · Texas Medicaid nursing facility (HHSC statewide rates) | $101.39since 2021-09-01 | unit | — | Plans negotiate; applies out of network | — | HHSC PFD NF rehabilitative and specializ |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $55.62since 2023-07-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $46.35since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $46.35since 2024-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $46.35since 2019-05-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $46.35since 2020-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Clinical Lab fee schedule (2 |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $46.35since 2018-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $44.47since 2024-02-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| ArizonaClinical nurse specialist · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $41.72since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Clinical |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $41.72since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Independent L |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $41.72since 2022-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, May 2023 |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $40.87since 2024-09-01 | — | — | Plans negotiate; applies out of network | — | Rates for Clinical Laboratory Services ( |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $38.38since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $37.08since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $37.08since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $34.76since 2021-04-01 | — | — | Plans negotiate; applies out of network | — | ODM laboratory services payment schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $31.57since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| PennsylvaniaRegistered nurse (RN) · Pennsylvania Medical Assistance (fee-for-service) | $19.00since 2017-08-07 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $15.20since 2015-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $11.09since 2018-10-01 | — | — | Not classified | — | MaineCare Fee Schedule (MaineCare UCR, H |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for G0472?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $41.72. Texas pays the most ($101.39 per unit) and Maine the least ($11.09).
Which state pays the highest Medicaid rate for G0472?
Texas, at $101.39 per unit, effective 2021-09-01.
Do managed-care plans pay the same rate for G0472?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.
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Track G0472 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.